Individual
MRS. TAMARA MAHR SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3100
(434) 517-3168
Mailing address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3100
(434) 517-3168
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
L001035
NC
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
L001305
NC
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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